Medical privacy and steps/girlfriend/boyfriends

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lilyflower236

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Medical privacy and steps/girlfriend/boyfriends
« on: June 15, 2016, 02:02:02 PM »
This came up in another sort-of unrelated thread by I want to see what you all think or your experiences on this has been.

My ex-husband likes to bring his girlfriend into the exam rooms when our 5-yr-old son has appointments. There's a long history of abusive behavior from her toward me -- parental alienation, cussing me out, sending hateful text messages to me, etc. etc. She's been angling for a confrontation with me for years, but I ignore her fits and don't engage. It's been going on for three years. She gets in these tiny exam rooms and likes to dominate the conversation. I feel like if both mother and father are present, then a parent's new partner does not need to be there. I don't bring my boyfriend to these medical appointments, any important information can be relayed to a gf/bf later if they are involved the child's care. My ex never ask me if it's ok, he says his gf has his permission and I can't do anything about it. The one time I've asked her to wait in the waiting room (at my son's outpatient surgery this spring), she yelled that I was an "evil c@nt" and tried to shove me out of the way. It was horrible. This woman's presence causes the stress levels to rise quite a bit and makes it hard to concentrate on my son's medical care. (She also goes to parent-teacher conferences but I just schedule a separate one, the schools won't do anything about the issue so I've let it go as best I can).

I've read HIPAA regulations and it's unclear if this is a violation. While a girlfriend/boyfriend/stepparent has no legal ability to make medical decisions for a nonrelated minor (unless legally adopted), it says a person can be appointed "in loco parentis" by one of the legal guardians, and be allowed to obtain medical records and attend appointments. It appears this is what my ex-husband basically has done. We have joint physical and legal custody. He insists because it's 50/50, his permission is all that is needed for her to be in the exam rooms even over my objections.

I have been told I can get a doctor's order that says only mom and dad are allowed in exam rooms. But from my experience, medical professionals are loathe to get involved. And I get it, it's not their job to referee parents, their responsibility is to provide medical care to the patient. One medical center my son was at, they did have a written policy of two legal guardians only allowed back, but they did not enforce it. Other places have no policies and let whoever come into exam rooms. At the most recent incident I told the nurse I felt unsafe with her there, and they just shrugged.

I'm asking in particular because I'm getting ready to probably have my son evaluated for ADHD and/or sensory processing problems at the suggestion of his kindergarten teacher. I'm already anticipating it being a nightmare of her interference. Dad has ADHD and has indicated in the past that he is supportive of interventions if our son exhibits some of the same problems in school, the earlier the better. But his gf tries to pass herself off as this all-natural, free-spirit type who hardly ever takes her own kids to the doctor, much less vaccinates them. She loves to give my son her "natural remedies" when he's sick. I'm afraid she may interfere, if anything because she always wants to pick a fight with me.

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sweetpea79

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #1 on: June 15, 2016, 05:26:02 PM »
Make the appointment when both you and father can go together, that way girlfriend is not needed in the room..
If Father or you are taken him to appointments on your own and this is an issue, I say get it in court order that each "legal" parent needs to be present at the time of any medical appointment, I feel this will resolve any issue and both parents will be there to get the best care for your child.
As far as medical records and making appointments, also get court order that only "legal" guardians are allowed to obtain records and make appointments.
It stinks having to go back to court.. But you have to do what you have to do.. When you deal with PD..

I can tell you in my experience with my SD, I would make appointments, requests records and be with my H when he "rarely" got to take SD to the doctors.. I was also doing all of the medical insurance stuff. My H worked full time and managed BM.. Full time.. Sometimes its a two person job, if the other parent isnt doing their job fully.. IME.. But if both you and Dad want to be fully involved, then what is stated above should work.
I would state to you ex and gf.. Although I understand you care and love child, this needs to be between father and I. What happens at their home and how they parent, is kind of beyond your control.. As long as your child is safe and being taken care of..

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Stepping lightly

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #2 on: June 15, 2016, 06:47:50 PM »
Hi Lily,

We have a similar problem..slightly different.  BM always brings her boyfriend to appts, and she refuses to allow DH to give the doctor's any information...and if she does..she will usually follow-up with an accusation in front of the kids/doctor.  She has blocked DH from exam rooms, she actually lies to the doctors to try and force diagnoses to gain footing on the "medical negligence" platform.  She back dates the start of symptoms into DH's week so that it looks like they always get sick at our house.  She says she brings her bf because she alleges she was abused by DH and she's so scared (sigh).  This results in BM/BF having 2 witnesses for what doctor said against DH alone, and they are happy to brainwash the kids to their side as well.  For this reason, I went a few times.  Yep...all FOUR parents crammed in the room, that was the most excrutiating hours of my life.  I thought a vein was going to blow in my forehead, I could feel it.  I don't go anymore, I like my mental health the way it is.  I won't even get into the circus that is picking up prescriptions!

It's definitely best to attempt to leave the medical staff as far out of the conflict as possible.   How old are your children?   Does the GF work and you can try and schedule the appt when she can't attend?  I mean, I believe both parents have a right to be there...but cramming all of the parents into an exam room is just a recipe for problems.

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gaslightedbug

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #3 on: June 15, 2016, 07:10:33 PM »
I work in HR not directly with medical like nursing or anything but the way I read the laws it is a violation unless both parents say it's okay. You having issue with a non-related person going into an exam room should be taken seriously by the office. At this point there's not much you can do and in the end I doubt ex will get in trouble. It would be the office you would ultimately go after but only once you say it's not okay. Right now all ex has to say is you are okay with it. My attorney said in family court this type of thing holds no weight as ex will just tell them anyways and they can't control that.

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gaslightedbug

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #4 on: June 15, 2016, 07:13:30 PM »
I spoke to my attorney about it due to suspicion of pas and emotional abuse by gf and the sensitivity of bringing it up with her in the court room.

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Associate of Daniel

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #5 on: June 15, 2016, 10:29:27 PM »
Hi, Folks,

We don't have as much in law to depend on where I am when compared with what I'm reading in your posts.

The only recourse I have it seems is to spend $1000s on changing the court orders and then that can only happen if negligence/harm is proven to be being done to the child.

Fortunately there is nothing physical going on towards me or my ds, although smum tends to smother him in physical affection.

Even if there was a law or policy in place it is unlikely she or my ex would take any notice.  I've once had to have a mediator remove her from the building. She and ex knew she wasn't allowed there but she came anyway.

(As an aside:  mediation:  Ha!

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Sunny

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #6 on: June 16, 2016, 03:05:15 AM »
Hi lilyflower236; if your ex's GF is not his wife, and/or has not adopted your son or assumed guardianship, then I suspect all you have to do is state at the beginning of the appointment/check in for surgery/etc that you do not authorize her to be present. I work in the health care field, and if you mention her presence "violating HIPAA rules" as health information will likely be disclosed to an unauthorized (by YOU because you are the child's mother) party, the nurses, staff, and docs will get this stricken look on their faces and ask her to leave or better yet, prevent her from entering.  Let her and ex-h spend the money on court to try to shoehorn her back in after the fact.

This is purely my opinion garnered from years and years of robotic computerized HIPAA training at work, but it is pretty clear on the face of it: no one who is not the patient, or the patient's "authorized representative" (and this needs to be in writing for adults; for kids it is the legal parent or guardian) is authorized to "receive" patient information. By watching your kid get an exam and listening to the doc's opinion etc, she is clearly "receiving" protected health information as it is known in HIPAA-speak.

If it were me in your shoes, I would try showing up early for the next appt., and approaching the front desk and openly telling them that so-and-so is likely to come with your ex, is not related to the child, and does not have any legal standing so you do not "authorize" her to be present during any medical anything.

Then I would stand back and let them do their job, which is to NOT DISCLOSE anything to any unauthorized person about a patient (your child's) protected health information. If ex-h wants her there, he can try to force them to let her in, but I bet they won't let it happen if you speak up first and invoke HIPAA.  The GF has her own kids to chaperone, not sure what she gains out of this other than a sense of entitlement and control. Your ex may not be the only one with a PD!!

OK just my 2 cents, hope your son is well!! Sunny

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kiwihelen

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #7 on: June 16, 2016, 03:38:35 AM »
This is an age dependent matter so tread carefully. My own experience (and I am a health professional so have been on the receiving end too!)is that I have not entered a treatment room (I won't even enter the premises) for the girl's primary care while they were considered under the age of competence. Once Eldest was over the age of competence I still checked with the clinic she was entitled to have a non-family member present and as part of the decision support.
I can advise that girlfriends or boyfriends throwing their weight around or one parent acting in a histrionic manner will result in "off the record" chats with the primary care doctor and most of the time the conversation let's us know about the divorce and any previous behaviour similar to what we had observed. My only concern comes if a specialist treatment plan that could have huge impact on the child's future well-being is not going to be followed. On one more memorable occasion I had a step parent give me excruciatingly detailed information on why the other household was "killing the kids with dietary choices" which I shot down with "and please tell me which school of nutrition your degree is from?"


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gaslightedbug

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #8 on: June 16, 2016, 11:00:12 AM »
I just wanted to add that even if ex was married that doesn't automatically give her permission to get medical information. But especially because they aren't married it is weird she goes!

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bopper

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #9 on: June 16, 2016, 12:32:16 PM »
. The one time I've asked her to wait in the waiting room (at my son's outpatient surgery this spring), she yelled that I was an "evil c@nt" and tried to shove me out of the way.

You need to stand firm. She has learned that yelling gets her way. Be the cool, calm collected but strong one.

Her: "evil c@nt"
You: Nevertheless, you are not his parent, you have no decision making powers, please leave the room. ExDH can fill you in later.
Her: more yelling
You: You are not his parent, please leave the room.
Her: It's okay with exDH
You: It's not okay with me. Please leave the room.
Just because they are incapable of loving you, doesn't mean that you are unlovable.
Anything makes the false self appear real is supply.

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lilyflower236

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #10 on: June 16, 2016, 01:16:50 PM »
Thank you for all the wonderful advice! I will definitely try to be more pro-active in the future to deal with this issue, and hopefully in the near future I can afford to get a third-party interference order in place. The health professionals who responded might be interested in exactly how the two surgery centers handled this:

Surgery center 1:
The forms said only mother and father (or two legal guardians) may be with the patient. When we checked-in, I told the nurse to please enforce this rule. But then that nurse went on break, and my ex ran and got his gf while my child was waiting in the pre-op cubicle. I was not prepared for that. I didn't say anything, because I didn't want to stress out my son more than he already was. But once they gave him some medicine to make him woozy, and he pretty much passed out, I asked her to leave. She did. I went back out and talked to the nurse again, and the gf was not allowed back into the post-op area.

Surgery center 2: When we went back for pre-op, the gf tried to go back with us. The nurse said "only mom and dad." The gf stayed in the waiting room. But when we got called back post-op, she came right along. I turned around (she was behind me) and told her to "please wait in the waiting room." She said no and tried to push past me. I said "there is a policy, and you need to respect boundaries." In the meantime, I could hear my son crying and screaming as he's coming out of the anesthesia. She starts cussing me and my ex keeps saying she has his permission. I turn to the three nurses standing there with their mouths agape, and ask them to please enforce their policy. I stated that this woman is not a legal guardian. The nurses don't do anything. The gf was yelling stuff like "oh, is it their policy or just your policy!!!!!" which really confused me. Finally one nurse stepped up and asked her to leave. My ex and I comfort our child, and 15 minutes later, he stands up and says he's going to get his gf and I'd "better not cause a scene again." He leaves the cubicle, and I tell a nurse that the verbally abusive woman was coming back here again, and I feel unsafe. He just shrugged and walked off. So the gf came back and I had to sit with them, in a tiny cubicle, holding my very upset child for the next 45 minutes. Best time of my life. I told my ex that I would never insist on bringing MY boyfriend to medical appointments over his objections. But ex said his girlfriend has a "special bond" with our child and has the right to be there.

I called the surgery center the next day and told them I was making a complaint to their accrediting agency. The administrator told me that they DID NOT have a policy about who was allowed into pre/post-op areas, that the nurse who told us that in the beginning was "mistaken." She claimed they'd never had an incident like that before so they didn't restrict access to patients. She lectured me about dealing with family problems at home, and how the staff's only responsibility is to their patient.  I told her regardless of if they had a policy on who was allowed to stay with the patient, this person was verbally abusing me and was becoming physical. How is that a safe environment for their patients? I asked if they had some sort of security there, for incidents like this, and she said no.

I was incensed and still prepared to make a complaint. The lady called me back the next day and we finally had a real conversation. She apologized and admitted fault. She said they were going to re-train their staff on violence in the workplace and review their policies. She seemed more genuine in that conversation.

So that's the two incidents. If my child has a regular doctor, dentist, or eye doctor appointment, my ex and his gf never show up. It's up to me to see he gets regular care.  But in high-stress situations like this, my ex comes and brings her along. I understand he needs a support person. I brought my mother as a support person to the first surgery, but she did not have the expectation of coming back to the patient area, and she didn't try.

Anyway, it's a mess. I can't seem to figure out if my ex has PD or if it's a combination of other issues he has. But there's no doubt in my mind his gf has PD, especially based on her turbulent relationships with other people and inability to hold down a job.

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sweetpea79

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #11 on: June 16, 2016, 05:24:59 PM »
I think when they say, "they have never had an incident like that" is a lie. I work in health care, i have seen it, i have lived in during personal life.. They just mean they had no answer for you on how to deal with your actions after the "ordeal" 
Your H will continue to do this and ask he GF to be present when she is not needed.. He won't change.

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Associate of Daniel

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #12 on: June 17, 2016, 06:29:50 AM »
Lilyflower, I'm so sorry for what you have experienced. It sounds truly awful but well done you for standing your ground. I wish I had had the courage to do that from the beginning.

I fear that in my case a precedent has been set. And that is partly due to me giving in because I didn't want to cause scenes in front of my ds.

The fact that he adores her has actually been helpful on some occasions. He listens to her more than he does me so she's been able to pursuade him to go through with some things (eg dentist) that I probably wouldn't have been successful at pursuading him to do. He's quite fearful and stubborn.

Recently he was supposed to have surgery. It was a second attempt as he chickened out the first time. This time I left it all to stepmum. I didn't say a word to him or her (ex arrived after it was all over) while at the hospital. When she arrived she immediately  took over, going into another room with him while I waited in the waiting room.

Whilst it's not good that he still didn't go through with the surgery, part of me is glad that the altogether perfect stepmum couldn't succeed, just as I couldn't.

AOG

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Associate of Daniel

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #13 on: June 17, 2016, 07:46:32 PM »
Hospital stuff is hard!

But I also struggle with normal appointments - dentist, optometrists etc. Court orders say both parents have equal decision making (or some such) so I feel bad about taking ds to appointments without informing his father first.

If I inform him, stepmum will probably go and take over. If I don't tell him I cop abuse.

My solicitor says I can take ds on my time and inform ds' s father later.

Then there's health insurance. My ex earns twice my entire income and his wife would be earning much the same as him, I suspect even more. They have a  top cover hospital and extras family policy which covers ds. I can't afford any health insurance. Fortunately in my country the public health system is very good and generally affordable.

Ex and his wife won't give me the policy number. So if I want to make any claims either they have to be there or I have to pay in full up front then give the paperwork to them, they make the claim and then reimburse me.

I'm at the point where I no longer trust them to reimburse me.

This has been the case for nearly 4 years and we've had several attempts to sort it out, including at mediation.  (Ha!)

Am I the only one in this situation?  Pretty much everyone I speak to about it shakes their head in disbelief.

AOD


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mamato3

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #14 on: June 20, 2016, 05:54:18 PM »
Can you ask the doctor's office for the copy of the insurance card? They must have it on file...that would help a little. Or even just writing down the policy number should be enough. I don't tell ex about routine medical appts. He doesn't come and isn't interested, so that's been a positive for me. He's a pain when he does show up to things, and isn't close enough to DS to have any helpful information anyway.

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Associate of Daniel

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #15 on: June 20, 2016, 07:50:59 PM »
Thanks, Mamato.  Whilst I understand the need for them, the privacy laws in my country are extremely tight. It's unlikely I would be given the policy number by the practitioners and certainly not by the insurance company.

One time I told ds' s father the details of an optometrist appointment i had booked. He didn't come. I reported the results to him and he had a written report from the optometrist sent to him.  I found out a few weeks later that his father had taken ds to a 2nd  appointment at a different optometrist.   The poor kid, having to go through all that again!  That's partly why I tell his father of the appointments and put up with smum's presence: so ds isn't dragged through unnecessary 2nd appointments.

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mamato3

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #16 on: June 20, 2016, 11:17:58 PM »
That sounds really annoying. I'm sorry :-(

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Associate of Daniel

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #17 on: June 21, 2016, 06:22:50 AM »
Thanks, Mamato.

It's good to read through these boards though. They remind me that my situation isn't as bad as many others.

AOD

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mamato3

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #18 on: June 21, 2016, 12:34:56 PM »
What is your custody arrangement AOD?

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Associate of Daniel

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Re: Medical privacy and steps/girlfriend/boyfriends
« Reply #19 on: June 22, 2016, 08:26:20 AM »
Ex has ds from Friday after school overnight and through to Saturday evenings. On alternate weekends it extends to Sunday morning. So 3 nights per fortnight. Also a few hours one night per week and half of school holidays.

AOD